Senior Healthcare Fraud Investigator
Medica
Medica seeks an SIU Investigator IV to lead advanced investigations into suspected fraud, waste, and abuse. This role is pivotal in managing complex cases, conducting specialized audits, and ensuring compliance with legal standards. The ideal candidate will have over 7 years of investigative experience, strong analytical skills, and be proficient in Microsoft Office. This position primarily operates onsite in Minnetonka, MN, and candidates must be authorized to work in the US. #J-18808-Ljbffr Medica
$70.2k - $105.32k
Medica is looking for an SIU Investigator IV to lead advanced investigations into fraud, waste, and abuse. This role requires overseeing complex cases, conducting audits, and collaborating with law enforcement. Candidates should have a bachelor’s degree and over 7 years...Senior$60.2k - $107.4k
UnitedHealth Group seeks a Senior Investigator to manage agent/broker complaints across various business lines while adhering to regulations... ...issues. Ideal candidates will have investigative and healthcare experience, with strong communication and analytical skills...SeniorRemote job- ...Job Description Description: Position Responsibilities The Fraud Risk Analyst is responsible for identifying emerging fraud... ...flagged for suspicious activity, using strong analytical and investigative skills to determine legitimacy and risk. Operating in a fast-paced...SuggestedWork at officeFlexible hours
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...Clinical Manager for Advisory Services, offering flexibility to work remotely across the U.S. This leadership role involves managing healthcare provider engagements, optimizing care models, and ensuring alignment with best practices. Candidates need active licensure and...SeniorRemote job- Medica is seeking an Affordability Analyst to support data analysis and insights aimed at enhancing healthcare affordability. This role involves mentoring junior analysts, conducting comprehensive analyses, and collaborating with cross-functional teams to drive data-driven...Senior
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UnitedHealth Group is seeking an experienced AI/ML professional to join Optum AI, a leader in healthcare innovation. You will develop cutting-edge AI solutions, collaborate with various teams, and solve complex challenges in healthcare. This role allows flexibility to...SeniorRemote job$134.6k - $230.8k
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...Clinical Manager for Advisory Services who will leverage clinical expertise and project management skills to lead transformational healthcare initiatives. This remote role allows flexibility while focusing on access to care and medical group optimization. Ideal...SeniorRemote job$78.7k - $118.02k
Medica, a nonprofit health plan, is seeking a contract manager responsible for vendor contracting and negotiations. You will work closely with internal stakeholders to ensure contracts meet business needs. The role requires a bachelor's degree and 5+ years of experience...SeniorContract work- Optum is seeking an experienced AI/ML scientist to develop innovative healthcare solutions. This position allows for remote work from anywhere in the U.S., with a requirement of in-office work for certain areas. The ideal candidate should possess a Master's degree and...SeniorRemote jobWork at office
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A healthcare technology organization is seeking a Senior Clinical Application Director to lead implementations and optimizations of clinical workflows for its applications. The position requires substantial healthcare experience and proficiency with HealthEdge Guiding...SeniorRemote job- Stryker Corporation is seeking a Senior Consultant for its Payer Technology practice to lead digital transformation efforts in the healthcare sector. The ideal candidate will have extensive experience in digital consulting, specifically managing projects that drive efficiency...Senior
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A healthcare organization is seeking an Associate Director, Actuarial, to oversee key actuarial functions for Medicare ACO lines. The role requires a Bachelor's degree in Actuarial Science and at least 5 years of actuarial experience, with skills in analysis and modeling...SeniorRemote job- UnitedHealth Group is looking for a Senior Architect to define and manage the architectural direction of health care platforms. Candidates... ..., a strong background in AI/ML systems, and familiarity with healthcare ecosystems. This remote position comes with opportunities for...SeniorRemote jobWork at office
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...monitoring EDI processing, troubleshooting issues, and preparing documentation. The ideal candidate has over 5 years of experience in healthcare data environments, knowledge of EDI transactions, and strong SQL skills. A comprehensive benefits package is offered, including a...Senior$91.7k - $163.7k
UnitedHealth Group seeks an experienced AI/ML Software Engineer to lead innovative solutions in healthcare. You will design and develop AI-powered software, drive AI adoption, and mentor team members. Ideal candidates will have 6+ years in software engineering and 5+ years...SeniorRemote job- Optum is looking for a Senior AI/ML Software Engineer to design and implement cutting-edge AI/ML systems addressing healthcare challenges. The role allows remote work flexibility across the U.S. Candidates should have extensive experience in AI/ML, particularly in deploying...SeniorRemote job
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Texas Health Institute is seeking a Clinical Manager, Advisory Services - Remote to lead transformational engagements with healthcare providers. This role requires advanced clinical expertise, project management, and the ability to deliver results by improving access to...SeniorRemote job- UnitedHealth Group is looking for a Sr Director of AI/ML Engineering to lead transformative AI strategies within the healthcare sector. The successful candidate will blend strategic oversight with hands-on technical expertise in machine learning and AI, driving impactful...SeniorWork at officeLocal areaRemote work
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A leading healthcare company is seeking a Sr Actuarial Analyst ALDP in Minnetonka, MN. The ideal candidate will have a bachelor's degree and at least 2 years of actuarial experience, along with proficiency in Excel. Responsibilities include preparing Medicare Advantage...Senior$91.7k - $163.7k
National Asset Mgmt Incorporated seeks a Senior Rhapsody Interface Engineer to support healthcare integration efforts. This role combines platform administration with advanced technical leadership, focusing on the Rhapsody integration platform. The ideal candidate will...SeniorWork at officeRemote work$91.7k - $163.7k
Optum is looking for a Senior Underwriting Consultant to analyze health benefit plans and assess risks. The role allows for remote work... ...at least four days a week. Candidates should have 7+ years in healthcare underwriting and risk management, alongside excellent...SeniorRemote job$91.7k - $163.7k
UnitedHealth Group is seeking a Senior Rhapsody Interface Engineer / Server Administrator to maintain and enhance Optum's healthcare integration platform. This role requires expertise in managing the Rhapsody environment and offers the chance to work remotely from anywhere...SeniorRemote job- A leading healthcare technology company is looking for a Senior Manager of AI/ML Engineering to lead teams in building scalable machine learning platforms. This role requires strong technical leadership, experience in MLOps, and collaboration with various teams. Candidates...SeniorRemote job
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UnitedHealthcare is seeking a Senior Clinical Program Manager - Devices and Durable Medical Equipment. This role involves supporting... ...optimize access to medical devices and technology, requiring strong healthcare knowledge and analytical skills. The position is remote and...SeniorRemote job- A leading healthcare organization is seeking a Senior Inpatient Medical Coder to work remotely. The role involves assigning ICD-10 codes, providing feedback to healthcare providers, and maintaining coding quality standards. Candidates must have at least 3 years of inpatient...SeniorRemote jobFlexible hours
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A global health optimization firm is seeking a Senior Actuarial Consultant to enhance healthcare analytics. This role requires 4+ years of actuary experience, focusing on machine learning applications to improve health outcomes. You will design data programs and mentor...SeniorRemote work
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